HomeMy Public PortalAbout5116 C & D SERENO DR_Plumbing__ YlNITC(ft 6 ES N 11/76
APPLICATION FOR PLUMBING PERMIT
COUNTY LOS ANGELES///(� �p 6
DEPARTMENT OF COUNTY ENGINBER
BUILDING AND SAFETY DIVISION 7
FORAPPLICANTTO FILL IN(PRINTOR TYPE) BUILDING /6�
NUMBER FIXTURE OR ITEM • FEE ' ADDRESS SII(7sertAc ,DR.
WATER CLOSET LOCALITY
BATH TUB / NEAREST
CROSS ST
SHOWER OWNER Coll r-ptg_g
LAVATORY MAIL
ADDRESS
SINK CITY M TEL NO g"-3
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DISHWASHER CONTRACTOR_ CY W A2t) d
Z CLOTHES WASHER Lr✓
ADDRESS
SWIMMING POOL RECEPTOR
LAWN SPRINKLER SYSTEM CITY C 4 � � ,L?``- TEL NDSTATE
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'L WATER HEATER LK:ENSE NO b LICIASS
GAS SYSS5TEEyMEE OUTLETS DISTRI NO
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INDUSTRIAL
WASTE APPROVAL G
INSPECTION RECORD V
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Plan check fee Z
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check OPPIKonT
Name APPROY" - ATE I ECT SIGNATURE
UNDER Sh"WORK
Address
ROUGH PLUMBING
CRY Tel No GASPIPING
I HEREBY ACKNOWLEDGE YNAT 1 HAVE HEAD THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE ISCORRER AND AGREE TO COMPLY W mi ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING , HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGLSTEAED AMD/011 LICENSED AS PLUMBING FIXTURES Z
REWIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I THE GAS TEST S.
LEGAL OWNER OF AND INRXD TO RESIDE IN THEZOE:D ZBEMNL
PROPERTY UTIUTYCO NOTIFIED
SIGNATURE
OF PERIARTE FINAL
PLAN CHECK VALIDATION CK No CASH PERMIT VALIDATION �-,Lit K Nod ,CASH
181�MAR 21 5 D 67.00 A!.,
YC
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COUNTY OF LOS ANGELEfi TEMPLE CITY 8 0508 PLUMING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1105020005
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID
BUILDING ADDRESS
I ON FILE 1 1 5116 SERENO DR 1
IFEE DESCRIPTION QUANTITY DOM AMOUNT I TEMP CA 917803055
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET
15388-011-013 101 PERMIT ISSUANCE FEE 27 80 1 THOMAS PAGE 596 GRID H5 L0CALITY TEMPLE CITY Cl
1 127 PRESS REG DEVICE(S) 1 00 DEV 16 30 1
(TENANT 164 WATER PIPNG r= 1 1/2 1 00 LIN 16 30 (ISSUED ON PROCESSED BY PLAN BY
TOTAL FEES 60 40 105/02/11 SR
(OWNER TEL NO IF DATE F;NAI, BY CODE
IGOLDFARB DANIEL,HARRIET L (626) 357-1124- 1 ../1
1 518 BRADBURY RD 19/��1'/
1 MROV 910163705
IDESCRI PTION OF WORK I
WATER MAIN AND ONE PRESSURE REGULATOR
(APPLICANT TEL NO
ISALOME TEODOCIO VARGAS (213) 392-1640- I 1
14172 S NORMANDIE AV I ISPECIAL CONDITIONS
(LOS ANGELES 90037
I CONTRACTOR
(APPROVALS DATE INSPECTOR SIGNATURE
ISAL TT VARGAS PLUMBING (3 N
23) 292 -7683- 1 1
14172 NORMANDIE AVENUE LIC NO 11 UNDFR SLAB WORK
IL09 ANGELES CA 90037 772349 C36
WATFE,,9fW4ICE
ARCHITECT OR ENGINEER TEL NO IP IC Y METAL Y/N
- TROUGH PLUMING
LIC NO
(GAS PIPING
GAS VENT
IHOT WATER WATER
I I I
I PLUMBING FIXTURES
I I I
LAWA SPRINKLERS
I I I
IGAS TEST
I I
(UTILITY COMPANY NOTIFIED(
I I I
1 JGRAY WATER SYSTEM
I I I
I I I I I I
I I I
I I I
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I I I I I I
REPORT ID DPR263 ROUTE TO ES0508
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